This is a fantastic, prospective, large population based study which lacks some of the biases of previous publications focused on the topic of SCD in the young in association with sports activity. Once again, it reinforces the message that most cases of SCD in the young occur outside of the context of physical activity. It certainly must provide food for thought for any proponent of ECG screening young athletes to prevent sports associated SCD.
My question, however, is this: in the minority of young subjects who suffered SCD during or after sports activity (15%), was there a trend towards certain attributable pathologies, for instance cardiomyopathies? As the authors point out, exercise restriction is suggested as a blanket recommendation for a number of inherited cardiac pathologies - are there some insights from this research which could make these guidelines more practical and evidence based?
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